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Patient reported outcomes improve if antibiotic choice is directed from endoscopic culture results in chronic rhinosinusitis
The use of antibiotics in chronic rhinosinusitis (CRS) has been established as part of the EPOS guidelines, as has the role of taking swabs for microbiology culture. There has not been much literature however on whether tailoring antibiotics in response...
Facial reconstruction with polyethylene implants
Planning reconstructive surgery for complex craniofacial defects challenges even the most experienced of surgeons. In most cases surgery is undertaken to improve anatomical functioning. However the anatomical structure of these regions is also critical to facial aesthetics and patient satisfaction...
CSF leak – endoscopic or open repair?
Cerebrospinal fluid (CSF) rhinorrhoea is well known to the ENT surgeon. It commonly occurs secondary to a predisposing event such as accidental or iatrogenic trauma. When it occurs spontaneously, it can be associated with benign intracranial hypertension. The commonest CSF...
Smaller gauge voice prosthesis is effective in secondary trans-oesophageal puncture
Placement of voice prosthesis at the time of trachea-oesophageal puncture is well described using 20-French prostheses. There is debate about the optimal size of the prosthesis with work in the 1980s and 1990s supporting larger prostheses. The rationale was that...
Stimulation for tinnitus
Tinnitus is known to be inhibited by stimulation of the auditory system by stimuli such as acoustical, electrical and magnetic. Residual inhibition (RI) is when tinnitus is temporarily eliminated for a period of time lasting seconds, minutes, up to hours...
Local dexamethasone infiltration in tonsillectomy
Intravenous dexamethasone is routinely given during tonsillectomy for its effects on postoperative pain and nausea. This Chinese randomised study divided 240 children undergoing tonsillectomy into three groups, receiving either no steroid, intravenous dexamethasone, or the same amount of dexamethasone infiltrated...
Canal wall down with obliteration of cavity for paediatric cholesteatoma
The authors present evidence that canal wall down (CWD) surgery with primary obliteration is an effective way to treat paediatric cholesteatoma. Fifty-eight ears were operated on and follow-up was for five years on average. Residual cholesteatoma rate was 9.9% with...
Mastoid obliteration for canal wall down surgery
Surgery for acquired cholesteatoma is varied amongst surgeons with some only performing combined approach tympanoplasty. The change in lifestyle for patients with canal wall down surgery is significant and hence this group in Japan looked at 118 adult patients with...
Modified subciliary approach to the orbital floor
Fractures involving the lateral midface and orbital floor are routinely treated by maxillofacial surgeons. The surgical management requires access to the facial skeleton to reposition and free the soft tissues. There are three main approaches to the orbital floor: infraorbital;...
Clinical value of 3 T magnetic resonance imaging after intratympanic gadolinium injection in cases of delayed endolymphatic hydrops
Recurrent vertigo can continue after severe unilateral or bilateral hearing loss. This is a condition similar to Ménière’s disease, the diagnosis of which can be difficult. In this study intratympanic injection of gadolinium-diethylenetriamine penta-acetic acid dimeglumine was done in 25...
To use or not to use: absorbable sutures for facial wounds
This systematic literature review looked at studies comparing facial skin closure with absorbable versus non-absorbable sutures. Studies not published in English or looking at areas other than the head and neck, and studies focused on suture technique rather than material...
